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新型冠状病毒肺炎:免疫学、免疫发病机制及潜在疗法

COVID-19: Immunology, Immunopathogenesis and Potential Therapies.

作者信息

Bhardwaj Asha, Sapra Leena, Saini Chaman, Azam Zaffar, Mishra Pradyumna K, Verma Bhupendra, Mishra Gyan C, Srivastava Rupesh K

机构信息

Department of Biotechnology, All India Institute of Medical Sciences, New Delhi, India.

Department of Molecular Biology, ICMR-NIREH, Nehru Hospital Building, Gandhi Medical College Campus, Bhopal, India.

出版信息

Int Rev Immunol. 2022;41(2):171-206. doi: 10.1080/08830185.2021.1883600. Epub 2021 Feb 27.

Abstract

The Coronavirus Disease-2019 (COVID-19) imposed public health emergency and affected millions of people around the globe. As of January 2021, 100 million confirmed cases of COVID-19 along with more than 2 million deaths were reported worldwide. SARS-CoV-2 infection causes excessive production of pro-inflammatory cytokines thereby leading to the development of "Cytokine Storm Syndrome." This condition results in uncontrollable inflammation that further imposes multiple-organ-failure eventually leading to death. SARS-CoV-2 induces unrestrained innate immune response and impairs adaptive immune responses thereby causing tissue damage. Thus, understanding the foremost features and evolution of innate and adaptive immunity to SARS-CoV-2 is crucial in anticipating COVID-19 outcomes and in developing effective strategies to control the viral spread. In the present review, we exhaustively discuss the sequential key immunological events that occur during SARS-CoV-2 infection and are involved in the immunopathogenesis of COVID-19. In addition to this, we also highlight various therapeutic options already in use such as immunosuppressive drugs, plasma therapy and intravenous immunoglobulins along with various novel potent therapeutic options that should be considered in managing COVID-19 infection such as traditional medicines and probiotics.

摘要

2019冠状病毒病(COVID-19)引发了突发公共卫生事件,影响了全球数百万人。截至2021年1月,全球报告了1亿例COVID-19确诊病例以及200多万人死亡。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染导致促炎细胞因子过度产生,从而导致“细胞因子风暴综合征”的发展。这种情况会导致无法控制的炎症,进而引发多器官功能衰竭,最终导致死亡。SARS-CoV-2引发不受控制的固有免疫反应并损害适应性免疫反应,从而造成组织损伤。因此,了解针对SARS-CoV-2的固有免疫和适应性免疫的主要特征及演变,对于预测COVID-19的结局以及制定控制病毒传播的有效策略至关重要。在本综述中,我们详尽讨论了SARS-CoV-2感染期间发生的、与COVID-19免疫发病机制相关的一系列关键免疫事件。除此之外,我们还重点介绍了已在使用的各种治疗选择,如免疫抑制药物、血浆疗法和静脉注射免疫球蛋白,以及在管理COVID-19感染时应考虑的各种新型有效治疗选择,如传统药物和益生菌。

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